Background: Previous studies have focused on the effect of the peroneus longus tendon graft on the knee; in this study, we focused on its impact on the ankle. Injuries to the anterior cruciate ligament (ACL) are frequently observed in sports injuries. The peroneus longus tendon graft has rapidly gained a place in the literature; however, very few studies have been conducted on the foot-ankle region stability of this tendon. Purpose: To investigate the effect on this region of the peroneus longus tendon graft used in anterior cruciate ligament reconstruction (ACLR). Study Design: Case series, Level of evidence 4. Methods: The study included 20 out of 35 patients who met the inclusion criteria and had ACLR using a peroneus longus tendon graft at the same orthopaedics and traumatology clinic between January and December 2023. The demographic characteristics of the patients were recorded. Ankle strength measurements were performed, and all the patients were tested with the Y test, the flamingo test, the eyes closed balance test, and the standing on tiptoes test. The Foot and Ankle Disability Index and the American Orthopedic Foot and Ankle Score were recorded. Results: The dynamometer measurements of the donor side and the contralateral side were compared. No statistically significant difference was determined between the 2 sides with respect to the ankle eversion and plantar flexion strength measurements ( P = .096, P = .835, respectively). A significant result was obtained in the flamingo test ( P = .049). No statistically significant difference was determined between the 2 sides with respect to the anterior, posterior, and lateral distances of the Y test (78.8 vs 78.6 cm, P = .973; 96.6 vs 80.4 cm, P = .053; 89.5 vs 95.0 cm, P = .357, respectively). In the examination of ankle functionality, no statistically significant difference was determined in the Foot and Ankle Disability Index and the American Orthopedic Foot and Ankle Score of the 2 sides ( P = .798, P = .206, respectively). Conclusion: The peroneus longus tendon can be safely used as an alternative autograft in ACLR without causing donor site morbidity. There may be a deficit in balance test performance.

WHO IS MORE SUCCESSFUL IN A SPINAL SURGERY EXAMINATION? CHATGPT-3.5/4.0 OR A RESIDENT DOCTOR? - The Journal of Turkish Spinal Surgery

Aim: Lateral epicondylitis is one of the leading orthopedic problems encountered in daily practice. Treatments are more symptomatic than curative. Percutaneous drilling is a minimally invasive method that provides satisfactory results. The aim of this study was to evaluate patients who had undergone percutaneous drilling for chronic lateral epicondylitis. Material and method: The study included 31 patients who underwent surgical percutaneous drilling because of chronic lateral epicondylitis between 2018 and 2021. The patients were evaluated with respect to demographic characteristics, including age, gender, body mass index (BMI), occupation, education level, hobbies, dominant side, and smoking status. The VAS (Visual Analog Scale) pain scores, PRTEE score (Patient-Rated Tennis Elbow Evaluation - a lateral epicondylitis function scale), and Roles-Maudsly score were examined preoperatively and at one and 12 months postoperatively together with grip strength measured with a Jamar hand dynamometer. Results: Statistically significant improvements were determined in the VAS score during activity from 8.9 preoperatively to 2.06 at 12 months postoperatively (p<0.01), and in the PRTEE score, from 64.12 preoperatively to 20.61 at 12 months postoperatively (p<0.01). The Roles-Maudsly score at 12 months postoperatively was determined to be excellent in 13 (41.9%) patients, and good in 14 (45.2%). Mean grip strength increased from 69.55 before treatment to 90.97 at the end of 12 months postoperatively. Conclusion: Autobiological treatments are at the forefront of current treatments for tendinopathies. Percutaneous drilling is a closed method and can be considered an ideal method in the treatment of tendinosis caused by inflammation and mesenchymal stem cells (MSCs) contained in hematoma. It is also an advantageous treatment method for patients with aesthetic concerns as it does not leave any scar tissue and has a low risk of complications.

Introduction and aim: Tibial plateau fractures are one of the most complex and common intra-articular fractures encountered in trauma surgery. This study aims to evaluate the MRI intra-articular findings of patients with tibial plateau fractures treated surgically and the functional and radiological changes after surgical treatment. Materials and methods: A total of 91 patients admitted to our clinic between 2010 and 2019 and operated for tibial plateau fracture were identified from the hospital information system. Patients were excluded from the study if aged <18 years, if the radiographs and MRIs were not suitable for the measurements, or if they could not be contacted by telephone. The study was completed with 49 operated knees and 49 healthy knees of 49 patients. The patients were evaluated with respect to demographic characteristics, Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), Knee Injury and Osteoarthritis Outcome Score (KOOS) functional and clinical scores, Rasmussen, Kellgren-Lawrence, and Whole-Organ Magnetic Resonance Imaging Score (WORMS) radiological scoring, and meniscus and ligament pathologies examined on the follow-up MR images. Results: The patients comprised 39 males and 10 females with a mean age of 45.9±11.89 years, and a mean follow-up of 58.2±30.7 months. The fractures were seen to be 49% (n=24)in the lateral plateau, 6.1% (n=4) in the medial plateau, and 42.9% (n=21) were bicondylar fractures involving both plateaux. The KSKS knee score was satisfactory in 85.7% of the patients, the KSFS functional score in 89.7%, and the Rassmussen radiological score in 93.8%. In the KOOS subjective questionnaire, the mean points obtained were 430.7, and the mean total WORMS points were 34.2. According to the Kellgren-Lawrence grades, severe osteoarthritis (grade 3-4) developed in 18.3% (n=9) of the patients. Conclusion: Meniscus injuries that are overlooked at the time of the first injury or which may develop in the subsequent process were not found to seriously affect the functional outcomes of tibial plateau fractures. It can be considered that even if a ligament injury is seen to be accompanying the fracture at the time of the first trauma, the effect is not great in terms of prognosis, and the treatment can remain conservative, especially for collateral ligament injuries.

Purpose Achilles tendon injuries represent a major clinical challenge due to the tendon’s poor vascularity and limited regenerative capacity. Amlodipine, a dihydropyridine calcium channel blocker, has demonstrated antioxidant, anti-inflammatory, and vasodilatory effects in various tissues. However, its potential influence on tendon healing remains unexplored. This study aimed to evaluate the histopathological and biomechanical effects of amlodipine on tendon regeneration in a rat model of Achilles tendon rupture. Methods Forty-eight male Wistar albino rats (300–350 g) were randomly allocated into four groups (n = 12 each): C14, A14, C28, and A28. A complete Achilles tenotomy was surgically created and repaired using the Kessler technique. Animals received either physiological saline (control) or amlodipine besylate (5 mg/kg/day, oral gavage) for 14 or 28 days. Tendons were harvested for either biomechanical testing (tensile strength and elongation) or histopathological analysis (fibroblastic activity, neovascularization, inflammation). Results Amlodipine significantly enhanced fibroblastic activity and neovascularization at both time points compared to controls. Inflammatory scores decreased markedly from day 14 to 28 in the treatment group, indicating a strong anti-inflammatory effect (p < 0.01 for all). Biomechanical testing revealed significantly increased tensile strength (22.23 ± 2.89 N vs. 15.07 ± 3.79 N; p < 0.05) and elongation (4.90 ± 1.62 mm vs. 2.70 ± 0.68 mm; p < 0.05) in the amlodipine group by day 28. Conclusion Amlodipine appears to accelerate and enhance Achilles tendon healing by promoting fibroblastic proliferation, angiogenesis, and biomechanical strength, while reducing inflammation. These findings suggest a potential role for amlodipine as a pharmacologic adjunct in tendon repair; however, further mechanistic and clinical studies are warranted.

Objective: Talus OCD (Osteochondritis Dissecans) is a painful ankle pathology that affects the subchondral bone and cartilage. This study aimed to determine whether artificial intelligence could provide accurate and sufficient responses to frequently asked questions about this pathology. Material and Method: ChatGPT (Chat Generative Pre-Trained Transformer) version 4.0 was asked 10 questions selected from the frequently asked questions on the websites of various orthopaedic institutions. The responses were analyzed with the Mika and Discern accuracy scores. Readability was based on the Flesch-Kincaid Grade Level, Gunning-Fog Index, Coleman-Liau Index, Automatic Readability Index, Simple Measure of Gobbledygook Index, Gobbledygook Index, Fry Readability Graph, and the Raygor Readability Estimate. The Reading grade levels were stated as USA grade levels. Results: According to the Mika scoring system, the mean score of the responses was 2.1. The general responses were satisfactory and required minimal explanation. The mean Discern score was 48, seen to be an average response given. In the index measurements for readability, the mean points were 15.14, which was equivalent to the reading level of a 3rd year university student. Conclusion: Artificial intelligence is a promising technological development. The continuously developing world of medicine does not yet have the most up-to-date data, and the readability level was seen to be very high. It was seen that the responses were made without showing evidence, which was lacking in the literature.